Gautier M, Cohen H J
Dept. of Medicine, Duke University Medical Center, Durham, North Carolina 27710.
J Am Geriatr Soc. 1994 Jun;42(6):653-64. doi: 10.1111/j.1532-5415.1994.tb06866.x.
While multiple myeloma is an incurable disease for nearly all patients, current chemotherapy and supportive care can result in significant disease control and improved duration of survival and quality of life. With the average age of patients about 70, most of the high-dose curative strategies exclude the bulk of patients affected by the disease. Recent advances in understanding the biology and pathophysiology of myeloma have led to novel therapies aimed at altering drug resistance, improving duration of the plateau phase, interrupting the cytokine growth stimulation, and improving management of common complications including infections, anemia, and bone lesions. These latter approaches are not restricted to younger patients, and early evidence indicates that elderly patients are also likely to benefit.
虽然多发性骨髓瘤对几乎所有患者来说都是一种无法治愈的疾病,但目前的化疗和支持性护理可以显著控制疾病,并延长生存期和改善生活质量。患者的平均年龄约为70岁,大多数大剂量治愈性策略将受该疾病影响的大部分患者排除在外。最近在骨髓瘤生物学和病理生理学认识方面的进展带来了新的治疗方法,旨在改变耐药性、延长平台期、中断细胞因子生长刺激,并改善包括感染、贫血和骨病变在内的常见并发症的管理。这些方法并不局限于年轻患者,早期证据表明老年患者也可能从中受益。